Dr. Daren Heyland, MD, Critical Care Doctor, Founder of Plan Well Guide

Featured Article:

Recently published online in the British Medical Journal of Supportive and Palliative Care:

Randomised trial of a serious illness decision aid (Plan Well Guide) for patients and their substitute decision-makers to improve engagement in advance care planning

  • Study ran September 2017 to October 2019
  • Participants (n=66 patient and SDM dyads) were randomized to receive the intervention immediately or in three months
  • A research nurse ran the interactive Plan Well GuideTM (slides with voiceover) for the patient and SDM
    and completed the structured paper-based values clarification and preference questions with the patient when prompted by the decision
  • The outcome was a survey of the SDM’s readiness and confidence* for their role, measured three months later
  • The study was limited by recruitment challenges. It was difficult to recruit SDMs sometimes even when the patient was interested
  • The trial was stopped early because of difficulties with enrolling and following up the planned sample of 90 patient and SDM dyads
  • The mean change on the SDM survey favoured the Plan Well Guide group, but the difference was not statistically significant (mean difference =0.2 (95% CI: −0.3 to 0.6, p=0.39)
  • In a post-hoc subgroup analysis, there was a significant difference in favour of the Plan Well Guide group in participants with a lower-than- median baseline score compared with those at or above the median (mean difference=0.6, 95% CI: 0.03 to 1.2, p=0.04).

Articles by Year

November 25

Patient Education and Counseling, Volume 104 – Issue 4: Effect of “Speak Up” educational tools to engage patients in advance care planning in outpatient healthcare settings: A prospective before-after study

September 23

MedRxiv Preprint: Supporting decision-making on allocation of ICU beds and ventilators in pandemics

September 17

ICU Management & Practice, Volume 20 – Issue 3: Unmasking the Triumphs, Tragedies, and Opportunities of the COVID-19 Pandemic

September 1

Australian Critical Care, Volume 33 – Issue 5: Shared decision-making in the intensive care unit requires more frequent and high-quality communication: A research critique

August 11

The Royal College of Physicians and Surgeons of Canada: New tool helps patients plan for serious illness care

July 18 

Healthcare, MDPI, Volume 8 – Issue 3: Advance Care Planning (ACP) vs. Advance Serious Illness Preparations and Planning (ASIPP)

July 10

Ontario Hospital Association: Supporting Patients in Getting the Medical Care that Is Right for Them

June 3

Canadian Geriatrics Journal, Volume 23 – Number 2: The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care

June 1

Canadian Medical Protective Association Practically Speaking Podcast: COVID-19: Advance care directives

May 25

BMC Family Practice, Volume 21- Number 94: Exploring patient-reported barriers to advance care planning in family practice

May 21

Canadian Hospice Palliative Care Association: Become a CHPCA Associate or Affiliate / Provincial Member

May 1

Canadian Geriatrics Journal, Volume 23 – Issue 2: The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care

Journal of Post-Acute and Long-term Care Medicine, Volume 21 – Issue 5: A Multicenter Study to Identify Clinician Barriers to Participating in Goals of Care Discussions in Long-Term Care

April 28

Canadian Medical Association Journal, Volume 8 – Issue 2: A novel decision aid to help plan for serious illness: a multisite randomized trial

March 2020

The Annals of Family Medicine, Volume 18 – Issue 2: Effect of an Interactive Website to Engage Patients in Advance Care Planning in Outpatient Settings

March 25

Family Practice, Volume 37 – Issue 2: Primary care clinicians’ confidence, willingness participation and perceptions of roles in advance care planning discussions with patients: a multi-site survey

January 19

The Lancet: EClinicalMedicine, Volume 19: Advance care planning; we need to do it more, but it needs to be done differently

February 1, 2018

Journal of Pain and Symptom Management, Volume 55 – Issue 2: Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus 

January 1, 2018

Journal of Pain and Symptom Management, Volume 55 – Issue 1: Development and Psychometric Properties of a Survey to Assess Barriers to Implementing Advance Care Planning in Primary Care

December 6, 2017 

BMC Medical Informatics and Decision Making, Volume 17 – Number 164: Recognizing difficult trade-offs: values and treatment preferences for end-of-life care in a multi-site survey of adult patients in family practices

November 1, 2017

Journal of Cardiac Failure, Volume 23 – Issue 11: Barriers to Goals of Care Discussions With Patients Who Have Advanced Heart Failure: Results of a Multicenter Survey of Hospital-Based Cardiology Clinicians

September 1, 2017

BMJ Supportive & Palliative Care: Discordance between patients’ stated values and treatment preferences for end-of-life care: results of a multicentre survey

The Lancet: Oncology, Volume 18 – Issue 9: Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care

July 31, 2017

Canadian Medical Association Journal, Volume 189 – Issue 30: Validation of quality indicators for end-of-life communication: results of a multicentre survey

June, 2017 

Journal of Critical Care, Volume 39: Development and initial evaluation of an online decision support tool for families of patients with critical illness: A multicenter pilot study

May 1, 2017

Journal of Pain and Symptom Management, Volume 53 – Issue 5: Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel

April 1, 2017

Journal of Pain and Symptom Management, Volume 53 – Issue 4: Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey

September, 2016

Critical Care Medicine, Volume 44 – Issue 9: Predicting Performance Status 1 Year After Critical Illness in Patients 80 Years or Older: Development of a Multivariable Clinical Prediction Model

August 17, 2016

BMJ Quality & Safety: The prevalence of medical error related to end-of-life communication in Canadian hospitals: results of a multicentre observational study

April, 2015

JAMA Intern Medicine, Volume 175 – Issue 4: Barriers to Goals of Care Discussions With Seriously Ill Hospitalized Patients and Their Families: A Multicenter Survey of Clinicians